People ask me ‘what exactly do you do for a living?’. Because I’ve been around a bit I sometimes struggle to answer this concisely, so here’s a short summary:

My career and experience:

After ten years of traveling around the world, I began my career as a nurse eventually specialising in mental health. My appetite for learning took me through a degree in Social Policy and then into the world of healthcare I.T.

I spent the next decade working on clinical systems for American giant Shared Medical Systems, progressing from project manager to Senior Strategic Services Consultant of the US arm of the company, working with leaders of clinical teams in the NHS.

I then returned to work for the NHS, successfully revamping the Information and Technology department at an NHS Trust prior to a trust merger.

A spell in consultancy for a large Cancer Network followed, by leading two multi-organisational projects to identify the most effective information and prescribing systems. These brought clinical teams together to manage a complicated buying system in a much more efficient and cost effective way.

I am a NICE Medicines and Prescribing Centre Associate, sharing related information /guidance & learning with a diverse group of NICE Affiliates, and documenting outcomes. I also continue to practice as a mental health clinician, focusing on several areas including mental capacity assessments and medicines management.

Turn Up The Volume! 2 London 26th May 2017 – A Reflection on the event

Summary:

Two years ago, Steve Turner, Managing Director of Care Right Now CIC, launched the first Turn Up The Volume! Conference in Bristol inviting patients, carers, NHS and social care staff to come together for the first time to discuss the problems within the NHS.

‘It was billed as a patient safety event like no other,’ said Mr Turner, ‘and it certainly lived up to its promise. There were many emotional moments as people told their stories to a sympathetic audience. The aim was to share experiences in promoting patient safety as well as helping people to speak out safely about bad practice and bullying.’

Turn Up the Volume 2 aimed to take the conversation further, make more links and help bring about actions which make a difference.

This was a ‘bootstrap’ event, which was put together by people who care about the subject, many of whom gave up their own time to be involved. It was open to anyone with an interest in the subject.

Forty people attended the event, from all parts of the UK and beyond. Delegates were from a variety of backgrounds including health & care staff, patient and public whistleblowers and academics.

The event was organised with the support of Marianna Fotaki is Professor of Business Ethics at Warwick Business School, University of Warwick.

Feedback from the event, which is still coming in, is largely positive and all constructive. As a result resources are being added to the event web pages, and an action plan is being developed. This will be openly shared with all delegates and through the www.tutv.org.uk web pages and on twitter under the hashtag #tutvlondon .

Aims of the event:

To provide a safe space where all involved can listen and learn from each other.

Giving food for thought and ongoing reflection.

Providing an interactive and inclusive listening exercise, where we plan to help everyone use the experiences of all those affected by cultures of fear to drive forward real change.

Throughout the day emphasis was placed on be on transforming ideas into action, and moving beyond stereotypes.

Speakers and delegates:

The morning session was chaired by Colin Leys, emeritus professor of political studies at Queen’s University, Kingston, Canada, and an honorary research professor at Goldsmiths, University of London. He is co-chair of the executive management team of the Centre for Health and the Public Interest (CHPI).

In the morning we heard from Dr Alexis Bushnell, who is a Research Fellow on an ESRC Transformative Grant, examining post-disclosure survival strategies by organisational whistleblowers (with Dr. Kate Kenny and Professor Marianna Fotaki). Then from Tracy Boylin, Human Resource professional and whistleblower, who spoke on ‘How can we use this event to make a difference?, and outlined some of the NHS initiatives that are underway.

Following this we heard from inspirational nurse Joan Pons Laplana, who spoke on Whistleblower experience and survival. Joan tweets as @RoaringNurse and has 27.5K followers. He spoke of the support he needed to keep going and in particular how he was welcomed into the BME community and found support there.

This was preceded by a short outline by Steve Turner of what happened when concerns were listened to. He gave an example of a project which came about because concerns were raised and, thanks to an open leadership approach, resulted in long term (and measurable) patient safety improvements.

There followed an interesting and powerful discussion on the current culture, where many of the delegates expressed their concerns that it remains unsafe to speak out at the moment. This included reservations and serious concerns about the effect of the Freedom to Speak Up Guardian initiative.

The final talk for the morning was given by a current whistleblower, who wishes to remain anonymous, who outlined their current situation and the background to it. This was a disturbing story which paints a picture familiar to many whistleblowers, where patient safety concerns are turned into an employment issue and the focus is distorted in a complex web of bureaucracy, obfuscation and accusations.

The afternoon session was chaired by Fergus Walsh, BBC Medical Correspondent. Our guest speaker was Steve Bolsin, the man who blew the whistle on failings in paediatric heart surgery at Bristol Royal Infirmary. This led to the Kennedy inquiry, which vindicated his concerns and was a landmark in clinical governance. He subsequently found it impossible to find another position in the UK and moved to Australia, where he became director of critical care services at Geelong Hospital in Victoria, achieving world class outcomes with the adult cardiac anaesthetic service he started. He has honorary professorial positions at Monash and Melbourne Universities.

Steve gave an account of the events in Bristol which even today, nearly 30 years later, was a poignant reminder of what happens when people try to speak up and blow the whistle and a club culture closes ranks to protect themselves and their organisations. This led to a powerful group discussion and questions to and from the panel, and highlighted ongoing concerns.

The event concluded with a session on action planning, collecting ideas and keeping up the momentum.

Dr Steve Bolsin speaking at TUTV! 2 London

Next steps:

One of the main areas of feedback is that these type of events enable people to get together who normally never meet, and that the strength of this networking, and the non-hierarchical approach adopted, will help in delivering a just culture in health & care.

Specific actions proposed included:

Building links with academic institutions and existing research projects

Linking with the BME community and leaders, who suffer disproportionately as whistleblowers and were under represented at the London conference.

Building links with whistleblowing organisations

Setting up action learning projects e.g:

To find out more about all costs of victimisation of whistleblowers, (legal fees, settlement agreements, ‘garden leave’ etc…).

Looking at the effect on relatives of whistleblowers

Looking at whistleblowing in remote and rural areas

Introducing more visual displays such as one shown at the event the ‘cost of bullying in the NHS’ and using the hashtag #tutvlondon

Cost of bullying in the NHS display (figures for 7 hours) based on ACAS figures and the NHS staff survey

Promoting the Turn Up the Volume! model of engagement in England and beyond

Organiser’s comments:

‘The Turn Up event went well. I believe that together we moved things on a little. The event linked together more great people and academic institutions, and came up with some actions.

My aspiration for the movement is to demonstrate how (or if) this approach to ‘engagement’ events works. The main characteristics being that it’s open to all, non-hierarchical and aims to look at things from all angles.

My personal goal is to be able to return to the clinical work I nearly lost when I tried to raise concerns and was bullied. I was very lucky due to my unusual career, and my experience of both clinical work, troubleshooting and senor management. Many people aren’t so lucky and their continued exclusion is great loss to the NHS and Social Care. Not to mention the personal suffering and the failures to keep patients safe, which is why all genuine whistleblowers put their heads over the parapet in the first place.’

Resources:

Updates will be posted on the www.tutv.org.uk pages over the next few weeks.

We want the best health care system in the world, & the most efficient and effective system …

We have an opportunity to do things differently in Cornwall

How do we achieve this?

The challenges in Cornwall

There’s a huge amount going on with health and social care in Cornwall. Including the Sustainability and Transformation Plan [STP]; exposure of abuse and neglect in care homes; concerns over hospital closures, delayed discharges taking up hospital beds, and devolution of services on the way.

Although I have worked in health and care for over 30 years, I struggle to keep up with the issues and understand how services are organised. This isn’t helped by the current polarisation of views.

On the one hand we have a big dose of NHS and Council ‘spin’, excessive bureaucracy and even bullying. On the other hand we have public concern, often expressed around specific issues, and sometimes based on unfounded rumours.

Neither of these positions are helpful, and neither represent the vast majority of people (public, staff and patients) who just want good services delivered by kind people who are open, accountable and transparent.

#devocornwall

We have a great opportunity now with the devolution of health and care services. This will be realised if we all build bridges, and transcend the usual hierarchical boundaries. We all need to listen and learn. Everyone, to coin an overused phrase, needs to step out of their comfort zones.

Why we need to think differently?

Several community hospitals are under threat of closure, leading to anger and dominating the headlines. Less attention is given to identifying and measuring the benefits, and any disadvantages of community hospitals. For example, can they be staffed adequately, bearing in mind this means Doctors, Nurses, Physiotherapists, Radiographers, Dieticians, Speech and Language Therapists, Social Workers etc.? Is home care a viable option for patients and carers? Are there any creative options such as bringing back the old style ‘convalescence’? Is rural isolation and lack of public transport the major issue?

It’s becoming increasingly difficult to book a timely GP consultation. This has led to several inaccurate scare stories in the press about ‘cuts’ to face to face GP contacts. This needs deep thought as there are times when easy access to a GP on the ‘phone, or on-line, may actually be a better option. Access to health information from Community Pharmacies or in NHS run clinics in shopping centres, or better health information and advice available locally, may be more effective approach. Leaving GPs free to spend more time with those who need their help and expertise most.

It’s now widely accepted that the NHS and Social Care is underfunded. Despite this there is still a great deal of duplication and waste in the system. How many times have you been asked to repeat information to Health Professionals which others already have? Do some services overlap, and are there gaps? Do different organisations link seamlessly with other organisations? Are all services accessible to all? Many people have important stories to tell on these areas of inefficiency.

Now’s the time to talk about this, find out what’s planned, and take action together. ‘Patient engagement’ key component of the STP and #devcornwall.

Patients and public need to take the lead on this. It’s not the NHS or Cornwall Council’s plan it’s ours.

5 Reasons You Should Employ a Whistleblower

Over the past few years my role as CEO of SpeakInConfidence has brought me into contact with quite a few whistleblowers; It’s also brought me into contact with lots of the cases and stories of whistleblowers.

On starting down the path of becoming a whistleblower people will know it is likely to be the end of their career in the organisation they are in. Sadly it is all too often the end their chosen career in the sector they are in.

Imagine the conversation with your boss when you let them know about your decision:

Boss “How did the references on Jane Bloggs, your preferred candidate for head of Finance turn-out”

“Oh we are not bothering with those – she was fantastic in interviews, just what we need and references will only be pro forma as she left her last job following a successful whistleblowing case”.

So here are 5 reasons should seriously consider being clear that “Yes applications from whistleblowers are welcome”.

You have to be pretty committed to be a whistleblower – the journey can be a hard one – and you are probably hiring someone with a high degree of commitment rather than being a passive by stander.

Trust: If I am going to trust someone I have never met before, I think I would put whistleblowing high on the list of qualifications. Given that in the UK whistleblowers don’t gain financially, and risk a huge amount, chances are you are hiring someone who is exceptionally committed to doing the right thing.

Don’t you want to know you have people on your team who will have the courage to tell you if they think things are not headed in the right direction? How many mistakes can be avoided if you avoid group think? Is it really in your interests or those of your organisation to surround yourself with yes people?

Imagine the signal to your staff – “We don’t shun people who raise concerns – we hire them”. What does that say to the rest of your staff? Want to create an open honest culture – what better signal can you give.

It’s the right thing to do. Think you are an equal opportunities employer? Think you are a courageous manager? Well start acting like one. By all means fail to select someone because they cannot do the job, but not because they had the courage to speak up elsewhere.

Given the assumptions people sometimes make, unless it’s blindingly obvious from past conduct of your organisation, maybe it’s even time to make it explicitly clear “Whistleblowers welcome here”.

Tim Martin is CEO of SpeakInConfidence, the Anonymous Dialogue Platform.

There is evidence to suggest that informal “blacklisting” is taking place within the NHS following raising concerns.

To obtain further information on whether you consider you have been blacklisted you need to write to the Data Protection Officer of your last NHS employer and request your Electronic Staff Record [ESR] in full via a Subject Access Requested [SAR]. Seek further advice on whether the data within your ESR may be causing you detriment in obtaining future employment within the NHS. There may be a charge for this.

If your last NHS employer has now dissolved (e.g. PCT, SHA) you need to write or email to the Department of Health requesting a Subject Access Request for your ESR. Contact details are:
Reviews and Information Team
Legacy Closedown Team
Information and Group Operations Directorate
Department of Health
Richmond House
79 Whitehall
London
SW1A 2NS